From www.practice.com
Sunday, July 14, 2024
Ketamine vs Electroconvulsive Therapy for Treatment-Resistant Depression
Friday, July 12, 2024
Academia and the Media against free speech
From Jonathan Turley.
JT is on target.
---------------------------------------------------
“The First Amendment is Out of Control”: Academic and Media Figures Rally Against Free Speech
Below is my column in Fox.com on renewed attacks on free speech and the apologists for this anti-free speech movement, including most recently comedian Jon Stewart. From moves to amend the First Amendment to mocking those being targeted, the left is pushing back at polls and efforts to restore free speech values.
Here is the column:
“The First Amendment Is Out of Control.” That headline in a recent column in the New York Times warned Americans of a menace lurking around them and threatening their livelihoods and very lives. That menace is free speech and the media and academia are ramping up attacks on a right that once defined us as a people.
In my new book “The Indispensable Right: Free Speech in an Age of Rage,” I discuss how we are living in the most dangerous anti-free speech period in our history. An alliance of the government, corporations, academia, and media have assembled to create an unprecedented system of censorship, blacklisting, and speech regulation. This movement is expanding and accelerating in its effort to curtail the right that Supreme Court Justice Louis Brandeis once called “indispensable” to our constitutional system.
It is, of course, no easy task to convince a free people to give up a core part of identity and liberty. You have to make them afraid. Very afraid.
The current anti-free speech movement in the United States has its origins in higher education, where faculty have long argued that free speech is harmful. Starting in secondary schools, we have raised a generation of speech phobics who believe that opposing views are triggering and dangerous.
Anti-free speech books have been heralded in the media. University of Michigan Law Professor and MSNBC legal analyst Barbara McQuade has written how dangerous free speech is for the nation. Her book, “Attack from Within,” describes how free speech is what she calls the “Achilles Heel” of America, portraying this right not as the value that defines this nation but the threat that lurks within it.
McQuade and many on the left are working to convince people that “disinformation” is a threat to them and that free speech is the vehicle that makes them vulnerable.
It is a clarion’s call that has been pushed by President Joe Biden who claims that companies refusing to censor citizens are “killing people.” The Biden administration has sought to use disinformation to justify an unprecedented system of censorship.
As I have laid out in testimony before Congress, Jen Easterly, who heads the Cybersecurity and Infrastructure Security Agency, extended her agency’s mandate over “critical infrastructure” to include “our cognitive infrastructure.” The resulting censorship efforts included combating “malinformation” – described as information “based on fact, but used out of context to mislead, harm, or manipulate.” So, you can cite true facts but still be censored for misleading others.
The media has been running an unrelenting line of anti-free speech columns. Recently, the New York Times ran a column by former Biden official and Columbia University law professor Tim Wu describing how the First Amendment was “out of control” in protecting too much speech.
Wu insists that the First Amendment is now “beginning to threaten many of the essential jobs of the state, such as protecting national security and the safety and privacy of its citizens.” He bizarrely claims that the First Amendment “now mostly protects corporate interests.”
So free speech not only threatens your life, your job, and your privacy, but serves corporate masters. Ready to sign your rights away?
Wait, there is more.
There is a movement afoot to rewrite the First Amendment through an amendment. George Washington University Law School Professor Mary Anne Franks believes that the First Amendment is “aggressively individualistic” and needs to be rewritten to “redo” the work of the Framers.
Her new amendment suggestion replaces the clear statement in favor of a convoluted, ambiguous statement of free speech that will be “subject to responsibility for abuses.” It then adds that “all conflicts of such rights shall be resolved in accordance with the principle of equality and dignity of all persons.”
Franks has also dismissed objections to the censorship on social media and insisted that “the Internet model of free speech is little more than cacophony, where the loudest, most provocative, or most unlikeable voice dominates . . . If we want to protect free speech, we should not only resist the attempt to remake college campuses in the image of the Internet but consider the benefits of remaking the Internet in the image of the university.”
Franks is certainly correct that those “unlikeable voices” are rarely heard in academia today. As discussed in my book, faculties have largely purged conservative, Republican, libertarian, and dissenting professors. The discussion on most campuses now runs from the left to far left without that pesky “cacophony” of opposing viewpoints.
Experts at leading universities were fired or stripped of positions for questioning COVID claims. Conservative faculty have been hounded from schools and conservative sites have been targeted by government-funded programs. Thousands have been banned from social media.
What is particularly maddening for many in the free speech community is how the left has responded to opposition to censorship and blacklisting. Some are claiming to be victims by those who criticize their work to target individuals and groups as disinformation.
Others, like comedian Jon Stewart mock those who object to the erosion of free speech by noting that conservatives are making these objections on television or online. So, according to Stewart, how can there be a problem if you are able to still object? The suggestion is that there can be no threat to free speech unless people are completely silenced.
Stewart insists that “we are surrounded by and inundated with more speech than has ever existed in the history of communication.” In other words, because people can still speak, the well-documented systems of censorship and blacklisting must not be so bad.
It is not clear what Stewart would accept as sufficient censorship. In universities, polls show both faculty and students afraid to speak openly. The government has funded a host of programs to pressure the source of revenue of conservative sites and to target dissenting voices. Yet, because we are raising objections to these trends, Stewart laughs at the very notion that free speech is under fire. After all, he is doing just fine.
What appears to be a punchline to Stewart is a bit more serious for others who have their livelihoods threatened by the anti-free speech movement.
Stewart has the benefit of being a liberal comedian on a liberal network. Try being a conservative comedian today getting air time on most cable outlets or college campuses. Like so many academics, everything seems just fine to them. With the purging of opposition viewpoints, those who remain have little to complain about.
The effort to assure citizens that “there is nothing to see here” is belied by a massive censorship system described by one federal court as “Orwellian.” Conservatives face cancel campaigns and blacklisting in academic and media forums.
As I discussed in my new book, conservative North Carolina professor Dr. Mike Adams faced calls for termination for years with investigations and cancel campaigns. He repeatedly had to go to court to defend his right to continue to teach. He was then again targeted after an inflammatory tweet. He was done. Under pressure from the university, he agreed to resign with a settlement. Four years ago this month, Adams went home just days before his final day as a professor. He then committed suicide.
Many others have resigned or retired. For them, the anti-speech movement takes away everything that brings meaning to an intellectual life from publications to associations to even employment. It is a chilling message to others not to join the “cacophony of … unlikeable voices.”
Some citizens seem sufficiently afraid or angry to surrender their free speech rights. They have lost faith in free speech. For the rest of us, their crisis of faith cannot be allowed to become a contagion. We must have a reawakening in this country that, despite our many divisions, we remain united by this indispensable human right.
JT is on target.
---------------------------------------------------
“The First Amendment is Out of Control”: Academic and Media Figures Rally Against Free Speech
Below is my column in Fox.com on renewed attacks on free speech and the apologists for this anti-free speech movement, including most recently comedian Jon Stewart. From moves to amend the First Amendment to mocking those being targeted, the left is pushing back at polls and efforts to restore free speech values.
Here is the column:
“The First Amendment Is Out of Control.” That headline in a recent column in the New York Times warned Americans of a menace lurking around them and threatening their livelihoods and very lives. That menace is free speech and the media and academia are ramping up attacks on a right that once defined us as a people.
In my new book “The Indispensable Right: Free Speech in an Age of Rage,” I discuss how we are living in the most dangerous anti-free speech period in our history. An alliance of the government, corporations, academia, and media have assembled to create an unprecedented system of censorship, blacklisting, and speech regulation. This movement is expanding and accelerating in its effort to curtail the right that Supreme Court Justice Louis Brandeis once called “indispensable” to our constitutional system.
It is, of course, no easy task to convince a free people to give up a core part of identity and liberty. You have to make them afraid. Very afraid.
The current anti-free speech movement in the United States has its origins in higher education, where faculty have long argued that free speech is harmful. Starting in secondary schools, we have raised a generation of speech phobics who believe that opposing views are triggering and dangerous.
Anti-free speech books have been heralded in the media. University of Michigan Law Professor and MSNBC legal analyst Barbara McQuade has written how dangerous free speech is for the nation. Her book, “Attack from Within,” describes how free speech is what she calls the “Achilles Heel” of America, portraying this right not as the value that defines this nation but the threat that lurks within it.
McQuade and many on the left are working to convince people that “disinformation” is a threat to them and that free speech is the vehicle that makes them vulnerable.
It is a clarion’s call that has been pushed by President Joe Biden who claims that companies refusing to censor citizens are “killing people.” The Biden administration has sought to use disinformation to justify an unprecedented system of censorship.
As I have laid out in testimony before Congress, Jen Easterly, who heads the Cybersecurity and Infrastructure Security Agency, extended her agency’s mandate over “critical infrastructure” to include “our cognitive infrastructure.” The resulting censorship efforts included combating “malinformation” – described as information “based on fact, but used out of context to mislead, harm, or manipulate.” So, you can cite true facts but still be censored for misleading others.
The media has been running an unrelenting line of anti-free speech columns. Recently, the New York Times ran a column by former Biden official and Columbia University law professor Tim Wu describing how the First Amendment was “out of control” in protecting too much speech.
Wu insists that the First Amendment is now “beginning to threaten many of the essential jobs of the state, such as protecting national security and the safety and privacy of its citizens.” He bizarrely claims that the First Amendment “now mostly protects corporate interests.”
So free speech not only threatens your life, your job, and your privacy, but serves corporate masters. Ready to sign your rights away?
Wait, there is more.
There is a movement afoot to rewrite the First Amendment through an amendment. George Washington University Law School Professor Mary Anne Franks believes that the First Amendment is “aggressively individualistic” and needs to be rewritten to “redo” the work of the Framers.
Her new amendment suggestion replaces the clear statement in favor of a convoluted, ambiguous statement of free speech that will be “subject to responsibility for abuses.” It then adds that “all conflicts of such rights shall be resolved in accordance with the principle of equality and dignity of all persons.”
Franks has also dismissed objections to the censorship on social media and insisted that “the Internet model of free speech is little more than cacophony, where the loudest, most provocative, or most unlikeable voice dominates . . . If we want to protect free speech, we should not only resist the attempt to remake college campuses in the image of the Internet but consider the benefits of remaking the Internet in the image of the university.”
Franks is certainly correct that those “unlikeable voices” are rarely heard in academia today. As discussed in my book, faculties have largely purged conservative, Republican, libertarian, and dissenting professors. The discussion on most campuses now runs from the left to far left without that pesky “cacophony” of opposing viewpoints.
Experts at leading universities were fired or stripped of positions for questioning COVID claims. Conservative faculty have been hounded from schools and conservative sites have been targeted by government-funded programs. Thousands have been banned from social media.
What is particularly maddening for many in the free speech community is how the left has responded to opposition to censorship and blacklisting. Some are claiming to be victims by those who criticize their work to target individuals and groups as disinformation.
Others, like comedian Jon Stewart mock those who object to the erosion of free speech by noting that conservatives are making these objections on television or online. So, according to Stewart, how can there be a problem if you are able to still object? The suggestion is that there can be no threat to free speech unless people are completely silenced.
Stewart insists that “we are surrounded by and inundated with more speech than has ever existed in the history of communication.” In other words, because people can still speak, the well-documented systems of censorship and blacklisting must not be so bad.
It is not clear what Stewart would accept as sufficient censorship. In universities, polls show both faculty and students afraid to speak openly. The government has funded a host of programs to pressure the source of revenue of conservative sites and to target dissenting voices. Yet, because we are raising objections to these trends, Stewart laughs at the very notion that free speech is under fire. After all, he is doing just fine.
What appears to be a punchline to Stewart is a bit more serious for others who have their livelihoods threatened by the anti-free speech movement.
Stewart has the benefit of being a liberal comedian on a liberal network. Try being a conservative comedian today getting air time on most cable outlets or college campuses. Like so many academics, everything seems just fine to them. With the purging of opposition viewpoints, those who remain have little to complain about.
The effort to assure citizens that “there is nothing to see here” is belied by a massive censorship system described by one federal court as “Orwellian.” Conservatives face cancel campaigns and blacklisting in academic and media forums.
As I discussed in my new book, conservative North Carolina professor Dr. Mike Adams faced calls for termination for years with investigations and cancel campaigns. He repeatedly had to go to court to defend his right to continue to teach. He was then again targeted after an inflammatory tweet. He was done. Under pressure from the university, he agreed to resign with a settlement. Four years ago this month, Adams went home just days before his final day as a professor. He then committed suicide.
Many others have resigned or retired. For them, the anti-speech movement takes away everything that brings meaning to an intellectual life from publications to associations to even employment. It is a chilling message to others not to join the “cacophony of … unlikeable voices.”
Some citizens seem sufficiently afraid or angry to surrender their free speech rights. They have lost faith in free speech. For the rest of us, their crisis of faith cannot be allowed to become a contagion. We must have a reawakening in this country that, despite our many divisions, we remain united by this indispensable human right.
Sunday, July 07, 2024
The Unintended and Anticompetitive Consequences of Laws to Control Health Care Costs
From jamanetwork.com.
A lesson in economics.
Good intentions do not equate to good fixes.
Here is the Link,
Here are some excerpts.
An array of federal and state laws, and accompanying regulations, restrict the supply of health care, driving up costs and making health care less affordable and accessible for many in the US. Too few health policy analysts and commentators have paid attention to these supply-side limitations that play a significant role in limiting the number of clinicians and health care facilities.
Even though some of these policies were well-intentioned and designed to control costs, they have, in practice, undermined competition and ironically led to higher prices in the long run.
Nowhere has this policy challenge been more acute than with respect to the available supply of hospitals across the country. Between 1974 and 2015, the number of hospitals in the US decreased by 22%. This shortage has been particularly severe in rural areas, where a 2017 study estimated that nearly 30 million individuals lived more than 1 hour from a trauma care facility.1 There is also a dearth of new hospital construction and expansions or renovations of older facilities (particularly in states with strict seismic retrofitting requirements, such as California). This shortage of health care facilities, coupled with clinician shortages, contributes to extended wait times for patients.
The health care industry has failed to respond with more facilities because policymakers passed laws that were designed to constrain hospital spending, but counterintuitively have done the opposite. For example, during the 1970s, certificate-of-need (CON) laws were passed in 26 states to constrain costs, but also to ensure access to care in rural or other historically underserved communities. As recently as 2022, CON laws require a state health planning agency or other regulatory agency to approve the expansion or construction of new facilities, or the offering of new service lines at a hospital, based on demonstrated community need and financial viability. This regulatory review process was designed to ensure, for example, that services were not duplicated in a single community. CON laws have generally been applied to hospitals, but are also applied to outpatient and long-term care facilities. In some states, CON review extends to mergers and acquisitions or changes in corporate control at some health care facilities.
In 1974, Congress hastened the adoption of state CON laws by passing the National Health Planning and Resources Development Act that tied federal funding to states passing their own CON laws. The results of this policy were predictable as, within years, nearly all states had adopted these rules that were designed to restrict new spending by ensuring an existing need for new medical facilities. In 1987, Congress repealed the federal inducements for CON laws because the laws proved to be ineffective in meeting their original purpose, and also because Congress itself changed the way in which hospitals were reimbursed under Medicare, rendering the laws largely unnecessary. Although 12 states rapidly eliminated their CON laws, they remain widespread, and as of January 2024, 35 states and the District of Columbia still had laws restricting the supply of new or renovated hospitals and other care facilities.
The COVID-19 pandemic illustrated the troublesome consequences of CON laws. During the pandemic, states with CON laws restricting the number of beds had 12% higher use rates and hospitals in those states were 27% more likely to have all their beds filled.3
Beyond the CON laws, other policies have undermined the development of new hospitals and raised prices for consumers. States have increasingly passed so-called certificates of public advantage (COPA) laws, which shield hospital mergers from certain federal antitrust laws. In states with COPA laws, hospitals can combine but, in return, regulators exercise additional oversight of postmerger policies and prices. The Federal Trade Commission recently reported that several hospital mergers conducted under COPA laws resulted in higher prices and reduced quality of care.
In 2010, Section 6001 of the Affordable Care Act (ACA) placed restrictions on physician-owned hospitals (POHs) and other health care facilities because of concerns that the ownership structure would lead to performance of unnecessary procedures and higher health care costs. The restrictions extend to the physicians’ immediate family members as well. The ACA included restrictions on the expansion of existing POHs and a requirement that POHs meet certain criteria to maintain eligibility for Medicare payments. The ACA’s restrictions on POHs include an exception for ownership or investment interests in rural facilities.
But the ACA restrictions on POHs have only served to limit market competition by limiting the creation of new facilities and restricting the size of existing POHs. Even though the ACA does not prohibit the existence of POHs, it has had chilling effects because of the primacy of Medicare payments to clinicians and hospitals. Miller and colleagues have noted that the impending imposition of the ACA restrictions several years ago led to the cancellation of 45 hospital expansion projects, and an additional 75 new hospital projects were “prematurely terminated.” These projects represented billions of dollars in lost economic activity—not to mention the loss of competitive pressure that had the potential to expand competition and lower costs for patients.
Together, CON and COPA laws, as well as the ACA restrictions on POHs, have been associated with a host of unintended consequences, such as the aggregation of market power in increasingly larger health care facilities, limited access to care, and higher costs for patients. Indeed, these supply-side restrictions have been critiqued by analysts across the ideological spectrum. Policymakers at both the state and federal level should take note of the unintended effects of these laws and their accompanying regulatory provisions and consider whether their repeal or modification would benefit patients and the communities where they live.
A lesson in economics.
Good intentions do not equate to good fixes.
Here is the Link,
Here are some excerpts.
An array of federal and state laws, and accompanying regulations, restrict the supply of health care, driving up costs and making health care less affordable and accessible for many in the US. Too few health policy analysts and commentators have paid attention to these supply-side limitations that play a significant role in limiting the number of clinicians and health care facilities.
Even though some of these policies were well-intentioned and designed to control costs, they have, in practice, undermined competition and ironically led to higher prices in the long run.
Nowhere has this policy challenge been more acute than with respect to the available supply of hospitals across the country. Between 1974 and 2015, the number of hospitals in the US decreased by 22%. This shortage has been particularly severe in rural areas, where a 2017 study estimated that nearly 30 million individuals lived more than 1 hour from a trauma care facility.1 There is also a dearth of new hospital construction and expansions or renovations of older facilities (particularly in states with strict seismic retrofitting requirements, such as California). This shortage of health care facilities, coupled with clinician shortages, contributes to extended wait times for patients.
The health care industry has failed to respond with more facilities because policymakers passed laws that were designed to constrain hospital spending, but counterintuitively have done the opposite. For example, during the 1970s, certificate-of-need (CON) laws were passed in 26 states to constrain costs, but also to ensure access to care in rural or other historically underserved communities. As recently as 2022, CON laws require a state health planning agency or other regulatory agency to approve the expansion or construction of new facilities, or the offering of new service lines at a hospital, based on demonstrated community need and financial viability. This regulatory review process was designed to ensure, for example, that services were not duplicated in a single community. CON laws have generally been applied to hospitals, but are also applied to outpatient and long-term care facilities. In some states, CON review extends to mergers and acquisitions or changes in corporate control at some health care facilities.
In 1974, Congress hastened the adoption of state CON laws by passing the National Health Planning and Resources Development Act that tied federal funding to states passing their own CON laws. The results of this policy were predictable as, within years, nearly all states had adopted these rules that were designed to restrict new spending by ensuring an existing need for new medical facilities. In 1987, Congress repealed the federal inducements for CON laws because the laws proved to be ineffective in meeting their original purpose, and also because Congress itself changed the way in which hospitals were reimbursed under Medicare, rendering the laws largely unnecessary. Although 12 states rapidly eliminated their CON laws, they remain widespread, and as of January 2024, 35 states and the District of Columbia still had laws restricting the supply of new or renovated hospitals and other care facilities.
The COVID-19 pandemic illustrated the troublesome consequences of CON laws. During the pandemic, states with CON laws restricting the number of beds had 12% higher use rates and hospitals in those states were 27% more likely to have all their beds filled.3
Beyond the CON laws, other policies have undermined the development of new hospitals and raised prices for consumers. States have increasingly passed so-called certificates of public advantage (COPA) laws, which shield hospital mergers from certain federal antitrust laws. In states with COPA laws, hospitals can combine but, in return, regulators exercise additional oversight of postmerger policies and prices. The Federal Trade Commission recently reported that several hospital mergers conducted under COPA laws resulted in higher prices and reduced quality of care.
In 2010, Section 6001 of the Affordable Care Act (ACA) placed restrictions on physician-owned hospitals (POHs) and other health care facilities because of concerns that the ownership structure would lead to performance of unnecessary procedures and higher health care costs. The restrictions extend to the physicians’ immediate family members as well. The ACA included restrictions on the expansion of existing POHs and a requirement that POHs meet certain criteria to maintain eligibility for Medicare payments. The ACA’s restrictions on POHs include an exception for ownership or investment interests in rural facilities.
But the ACA restrictions on POHs have only served to limit market competition by limiting the creation of new facilities and restricting the size of existing POHs. Even though the ACA does not prohibit the existence of POHs, it has had chilling effects because of the primacy of Medicare payments to clinicians and hospitals. Miller and colleagues have noted that the impending imposition of the ACA restrictions several years ago led to the cancellation of 45 hospital expansion projects, and an additional 75 new hospital projects were “prematurely terminated.” These projects represented billions of dollars in lost economic activity—not to mention the loss of competitive pressure that had the potential to expand competition and lower costs for patients.
Together, CON and COPA laws, as well as the ACA restrictions on POHs, have been associated with a host of unintended consequences, such as the aggregation of market power in increasingly larger health care facilities, limited access to care, and higher costs for patients. Indeed, these supply-side restrictions have been critiqued by analysts across the ideological spectrum. Policymakers at both the state and federal level should take note of the unintended effects of these laws and their accompanying regulatory provisions and consider whether their repeal or modification would benefit patients and the communities where they live.
Effectiveness and Safety of Apixaban vs Rivaroxaban in Older Patients With Atrial Fibrillation
From practice update.com.
Here is the Link.
Here are some excerpts.
----------
BACKGROUND
There are no clinical trials with head-to-head comparison between the two most commonly used oral anticoagulants (apixaban and rivaroxaban) in patients with atrial fibrillation (AF). The comparative efficacy and safety between these drugs remain unclear, especially among older patients who are at the highest risk for stroke and bleeding.
OBJECTIVE
To compare the risk of major bleeding and thromboembolic events with apixaban versus rivaroxaban in older patients with AF.
METHODS
We conducted a population-based, retrospective cohort study of all adult patients (66 years or older) with AF in Ontario, Canada who were treated with apixaban or rivaroxaban between April 1, 2011 and March 31, 2020. The primary safety outcome was major bleeding and the primary efficacy outcome was thromboembolic events. Secondary outcomes included any bleeding. Rates and hazard ratios (HRs) were adjusted for baseline comorbidities with inverse probability of treatment weighting (IPTW).
RESULTS
This study included 42,617 patients with AF treated with apixaban and 30,725 patients treated with rivaroxaban. After IPTW using the propensity score, patients in the apixaban and rivaroxaban groups were well balanced for baseline values of demographics, comorbidities and medications; both groups had similar mean age of 77.4 years and 49.9% were female. At one year, the apixaban group had reduced risk for both major bleeding with an absolute risk reduction at one year of 1.1% (2.1% vs 3.2%; HR 0.65 [95% CI, 0.59-0.71]) and any bleeding (8.1% vs 10.9%; HR 0.73 [95% CI, 0.69-0.77]) with no difference in the risk for thromboembolic events (2.2% vs 2.2%; HR 1.02 [95% CI, 0.92-1.13]).
CONCLUSIONS
Among AF patients, 66 years or older, treatment with apixaban was associated with reduced risk for major bleeding with no difference in risk for thromboembolic events compared with rivaroxaban.
Here is the Link.
Here are some excerpts.
----------
BACKGROUND
There are no clinical trials with head-to-head comparison between the two most commonly used oral anticoagulants (apixaban and rivaroxaban) in patients with atrial fibrillation (AF). The comparative efficacy and safety between these drugs remain unclear, especially among older patients who are at the highest risk for stroke and bleeding.
OBJECTIVE
To compare the risk of major bleeding and thromboembolic events with apixaban versus rivaroxaban in older patients with AF.
METHODS
We conducted a population-based, retrospective cohort study of all adult patients (66 years or older) with AF in Ontario, Canada who were treated with apixaban or rivaroxaban between April 1, 2011 and March 31, 2020. The primary safety outcome was major bleeding and the primary efficacy outcome was thromboembolic events. Secondary outcomes included any bleeding. Rates and hazard ratios (HRs) were adjusted for baseline comorbidities with inverse probability of treatment weighting (IPTW).
RESULTS
This study included 42,617 patients with AF treated with apixaban and 30,725 patients treated with rivaroxaban. After IPTW using the propensity score, patients in the apixaban and rivaroxaban groups were well balanced for baseline values of demographics, comorbidities and medications; both groups had similar mean age of 77.4 years and 49.9% were female. At one year, the apixaban group had reduced risk for both major bleeding with an absolute risk reduction at one year of 1.1% (2.1% vs 3.2%; HR 0.65 [95% CI, 0.59-0.71]) and any bleeding (8.1% vs 10.9%; HR 0.73 [95% CI, 0.69-0.77]) with no difference in the risk for thromboembolic events (2.2% vs 2.2%; HR 1.02 [95% CI, 0.92-1.13]).
CONCLUSIONS
Among AF patients, 66 years or older, treatment with apixaban was associated with reduced risk for major bleeding with no difference in risk for thromboembolic events compared with rivaroxaban.
Saturday, July 06, 2024
Hunga Tonga volcano: impact on record warming
By Javier Vinos.
Here is the Link.
Climate Change: settled or unsettled?
Here are some excerpts.
The climate event of 2023 was truly exceptional, but the prevailing catastrophism about climate change hinders its proper scientific analysis. I present arguments that support the view that we are facing an extraordinary and extremely rare natural event in climate history.
1. Off-scale warming
Since the planet has been warming for 200 years, and our global records are even more recent, every few years a new warmest year in history is recorded. Despite all the publicity given each time it happens, it would really be news if it didn’t happen, as it did between 1998 and 2014, a period popularly known as the pause.
Since 1980, 13 years have broken the temperature record. So, what is so special about the 2023 record and the expected 2024 record? For starters, 2023 broke the record by the largest margin in records, 0.17°C. This may not sound like much, but if all records were by this margin, we would go from +1.5°C to +2°C in just 10 years, and reach +3°C 20 years later.
Moreover, to produce so much warming, almost the entire globe experienced above-average warming. 2023 was a year of real global warming, although most of the warming occurred in the Northern Hemisphere.
--------------------------
Gavin Schmidt, director of NASA’s climate monitoring institute, also uses the expression “uncharted territory” when he explains that the 2023 anomaly worries scientists, saying that climate models cannot explain why the planet’s temperature suddenly spiked in 2023. Not only was the temperature anomaly much larger than expected, but it occurred months before the onset of El Niño. In his own words: “The 2023 temperature anomaly has come out of the blue, revealing an unprecedented knowledge gap perhaps for the first time since about 40 years ago. It could imply that a warming planet is already fundamentally altering how the climate system operates, much sooner than scientists had anticipated.”[iii] According to Gavin, we could have broken the climate and the models would no longer work.
Instead of abandoning science for wild speculation let’s examine the possible factors responsible for the abrupt warming that Gavin Schmidt dismisses by saying they could explain at most a few hundredths of a degree, for which he has little evidence.
Dismissing natural warming
On the one hand, we have an absolutely unprecedented abrupt warming that the models cannot explain and that has scientists scratching their heads. Such anomalous warming cannot logically respond to the usual suspects, El Niño, reduced sulfur emissions, or increased CO₂, which have been going on for many decades.
On the other hand, we have an absolutely unprecedented volcanic eruption, the effects of which we cannot know, but which, according to what we know about the greenhouse effect, should cause significant and abrupt warming.
Of course, we cannot conclude that the warming was caused by the volcano, but it is clear that it is by far the most likely suspect, and any other candidate should have to demonstrate its ability to act abruptly with such magnitude before being seriously considered.
So why do scientists like Gavin Schmidt argue, without evidence or knowledge, that the Tonga volcano could not have been responsible? If the effect were cooling, the volcano would be blamed without a second’s hesitation, but significant natural warming undermines the message that warming is the fault of our emissions.
Here is the Link.
Climate Change: settled or unsettled?
Here are some excerpts.
The climate event of 2023 was truly exceptional, but the prevailing catastrophism about climate change hinders its proper scientific analysis. I present arguments that support the view that we are facing an extraordinary and extremely rare natural event in climate history.
1. Off-scale warming
Since the planet has been warming for 200 years, and our global records are even more recent, every few years a new warmest year in history is recorded. Despite all the publicity given each time it happens, it would really be news if it didn’t happen, as it did between 1998 and 2014, a period popularly known as the pause.
Since 1980, 13 years have broken the temperature record. So, what is so special about the 2023 record and the expected 2024 record? For starters, 2023 broke the record by the largest margin in records, 0.17°C. This may not sound like much, but if all records were by this margin, we would go from +1.5°C to +2°C in just 10 years, and reach +3°C 20 years later.
Moreover, to produce so much warming, almost the entire globe experienced above-average warming. 2023 was a year of real global warming, although most of the warming occurred in the Northern Hemisphere.
--------------------------
Gavin Schmidt, director of NASA’s climate monitoring institute, also uses the expression “uncharted territory” when he explains that the 2023 anomaly worries scientists, saying that climate models cannot explain why the planet’s temperature suddenly spiked in 2023. Not only was the temperature anomaly much larger than expected, but it occurred months before the onset of El Niño. In his own words: “The 2023 temperature anomaly has come out of the blue, revealing an unprecedented knowledge gap perhaps for the first time since about 40 years ago. It could imply that a warming planet is already fundamentally altering how the climate system operates, much sooner than scientists had anticipated.”[iii] According to Gavin, we could have broken the climate and the models would no longer work.
Instead of abandoning science for wild speculation let’s examine the possible factors responsible for the abrupt warming that Gavin Schmidt dismisses by saying they could explain at most a few hundredths of a degree, for which he has little evidence.
Dismissing natural warming
On the one hand, we have an absolutely unprecedented abrupt warming that the models cannot explain and that has scientists scratching their heads. Such anomalous warming cannot logically respond to the usual suspects, El Niño, reduced sulfur emissions, or increased CO₂, which have been going on for many decades.
On the other hand, we have an absolutely unprecedented volcanic eruption, the effects of which we cannot know, but which, according to what we know about the greenhouse effect, should cause significant and abrupt warming.
Of course, we cannot conclude that the warming was caused by the volcano, but it is clear that it is by far the most likely suspect, and any other candidate should have to demonstrate its ability to act abruptly with such magnitude before being seriously considered.
So why do scientists like Gavin Schmidt argue, without evidence or knowledge, that the Tonga volcano could not have been responsible? If the effect were cooling, the volcano would be blamed without a second’s hesitation, but significant natural warming undermines the message that warming is the fault of our emissions.
Friday, July 05, 2024
Doing Hard Things
The story of Master Sgt. Roddie Edmonds, by Will Dabbs, MD
at American Handgunner.
Wacht am Rhein literally translates as “Watch on the Rhine.”
The name was taken from a popular German military marching song. Watch on the
Rhine was going to change everything.
Recognizing Greatness
Thursday, July 04, 2024
How Retired Corrections Officer Defended His Life and Liberty Against Violent Attackers
I have not verified the following but did ascertain that there was such a court case.
An overzealous prosecution such as described is not unheard of.
------------------------------------------
Retired Corrections Officer Kirk Culik and his wife live in Hillsdale County, Michigan. Hillsdale County is the home of Hillsdale College, known for its strict adherence to the United States Constitution. It is also where Culik not only had to defend himself from three attackers but also had to defend himself from an overzealous prosecutor.
In May of 2022, Culik, a U.S. A. Hockey U18 coach, was unloading groceries with his wife from his car when a teenager approached him. According to Mr. Culik and evidence presented in court, the teenage chest-bumped Mr. Culik before another sucker punched him. A third teen came up from behind Culik and smashed a wine bottle over his head, giving Culik a concussion. The three teens repeatedly punched and kicked him as he was on the ground. Mr. Culik believed his life was in danger.
Mr. Culik stated he did not know the teens carrying out the seemingly random attack but believed they might be trying to steal his truck. He was not and still is unsure, but he knew he was in serious trouble. Mr. Culik had the great equalizer. He was armed, and having trained at MDFI, he knew what he had to do to possibly save his life. He managed to reach his gun, firing one shot and hitting and killing one of the attackers. The others fled the scene.
Earlier on, the three teens went on a crime spree. They stole a boat and a car. They also vandalized a park, all the while doing drugs and drinking. Mr. Culik told his wife to call 911 after defending himself. He thought his ordeal was over, but once police arrived from the small police force, they arrested Mr. Culik on the spot. He didn’t have to invoke his right to remain silent because the police didn’t ask any questions. Less than an hour later, he was indicted for murder.
The cancer survivor faced a long, hard road ahead of him, but he refused to plead guilty. He would fight for his freedom in court, but the ordeal would cost him. Mr. Culik was denied bond for 90 days and sent to jail, where he would be placed in solitary confinement for 102 days. In those 102 days, the lights were never turned off. He was told he was in solitary confinement because of “COVID.” The three-time cancer survivor was also denied medical treatment for the same excuse for 72 days
Eventually, the bond would be set, but to everyone’s shock, it was the highest in Hillsdale’s history. Mr. Culik’s bond was set to a mind-blowing $400,000. Not only that, but the judge demanded that it be paid in full in cash. Most bonds work by someone coming up with 10% of the bond value. The judge insisted every penny be put up in this case. Luckily for Culik, his family came through. His sister mortgaged her house to get the money, and after spending 703 days in jail, he was out and ready to fight back in court. That is, if he could get a fair trial, which was in doubt since he could not get even the speedy trial promised by the U.S. Constitution.
Shortly after the trial began, Mr. Culik’s lawyer was tipped off by someone in the Michigan State Police that law enforcement had given over evidence to the prosecution in the form of drone footage. The prosecution did not turn over evidence to the defense even though they were required to until the defense demanded it. Without the tip-off, it would have never seen the light of day. The drone footage not only showed what happened but also that the prosecution’s two star witnesses were not present during the attack.
It also came to light that the judge held ex parte meetings without the defense being present. A similar situation happened in the Young Thug case in Atlanta, leading many to believe that the case will be overturned if the rapper is convicted of murder. This situation was very similar.
While the case continued, Mr. Culik’s wife had to leave their home due to death threats. Their lives were being turned upside down. The ordeal would not be quick. Finally, on April 23, 2024, Mr. Culik heard the words he was waiting two years to hear, “Not guilty.”
The media covered the initial incident, but when the facts of the case started coming out, those same papers remained silent. When the narrative was about a 62-year-old man gunning down a teen, the media were interested in reporting the news, but when it became a clear-cut case of self-defense, the coverage dried up.
Mr. Culik was free, but the process of his punishment was costly. Culik did not have any concealed carry insurance and spent over $200,000 on his legal defense. An innocent man was forced to sell everything he owned to fight for his freedom, but the folks at MDFI are stepping up to help.
MDFI has a program called “Operation Skywalker.” It is an alum program that helps those in need, and Mr. Culik is one of those alumni. The goal is to raise $100,000 to help Mr. Culik get back on his feet, although that only covers half his legal bills. When there is injustice, we must help those affected.
If you would like to donate to help Mr. Culik, you can do so by donating at https://www.givesendgo.com/OPERATIONSKYWALKER
An overzealous prosecution such as described is not unheard of.
------------------------------------------
Retired Corrections Officer Kirk Culik and his wife live in Hillsdale County, Michigan. Hillsdale County is the home of Hillsdale College, known for its strict adherence to the United States Constitution. It is also where Culik not only had to defend himself from three attackers but also had to defend himself from an overzealous prosecutor.
In May of 2022, Culik, a U.S. A. Hockey U18 coach, was unloading groceries with his wife from his car when a teenager approached him. According to Mr. Culik and evidence presented in court, the teenage chest-bumped Mr. Culik before another sucker punched him. A third teen came up from behind Culik and smashed a wine bottle over his head, giving Culik a concussion. The three teens repeatedly punched and kicked him as he was on the ground. Mr. Culik believed his life was in danger.
Mr. Culik stated he did not know the teens carrying out the seemingly random attack but believed they might be trying to steal his truck. He was not and still is unsure, but he knew he was in serious trouble. Mr. Culik had the great equalizer. He was armed, and having trained at MDFI, he knew what he had to do to possibly save his life. He managed to reach his gun, firing one shot and hitting and killing one of the attackers. The others fled the scene.
Earlier on, the three teens went on a crime spree. They stole a boat and a car. They also vandalized a park, all the while doing drugs and drinking. Mr. Culik told his wife to call 911 after defending himself. He thought his ordeal was over, but once police arrived from the small police force, they arrested Mr. Culik on the spot. He didn’t have to invoke his right to remain silent because the police didn’t ask any questions. Less than an hour later, he was indicted for murder.
The cancer survivor faced a long, hard road ahead of him, but he refused to plead guilty. He would fight for his freedom in court, but the ordeal would cost him. Mr. Culik was denied bond for 90 days and sent to jail, where he would be placed in solitary confinement for 102 days. In those 102 days, the lights were never turned off. He was told he was in solitary confinement because of “COVID.” The three-time cancer survivor was also denied medical treatment for the same excuse for 72 days
Eventually, the bond would be set, but to everyone’s shock, it was the highest in Hillsdale’s history. Mr. Culik’s bond was set to a mind-blowing $400,000. Not only that, but the judge demanded that it be paid in full in cash. Most bonds work by someone coming up with 10% of the bond value. The judge insisted every penny be put up in this case. Luckily for Culik, his family came through. His sister mortgaged her house to get the money, and after spending 703 days in jail, he was out and ready to fight back in court. That is, if he could get a fair trial, which was in doubt since he could not get even the speedy trial promised by the U.S. Constitution.
Shortly after the trial began, Mr. Culik’s lawyer was tipped off by someone in the Michigan State Police that law enforcement had given over evidence to the prosecution in the form of drone footage. The prosecution did not turn over evidence to the defense even though they were required to until the defense demanded it. Without the tip-off, it would have never seen the light of day. The drone footage not only showed what happened but also that the prosecution’s two star witnesses were not present during the attack.
It also came to light that the judge held ex parte meetings without the defense being present. A similar situation happened in the Young Thug case in Atlanta, leading many to believe that the case will be overturned if the rapper is convicted of murder. This situation was very similar.
While the case continued, Mr. Culik’s wife had to leave their home due to death threats. Their lives were being turned upside down. The ordeal would not be quick. Finally, on April 23, 2024, Mr. Culik heard the words he was waiting two years to hear, “Not guilty.”
The media covered the initial incident, but when the facts of the case started coming out, those same papers remained silent. When the narrative was about a 62-year-old man gunning down a teen, the media were interested in reporting the news, but when it became a clear-cut case of self-defense, the coverage dried up.
Mr. Culik was free, but the process of his punishment was costly. Culik did not have any concealed carry insurance and spent over $200,000 on his legal defense. An innocent man was forced to sell everything he owned to fight for his freedom, but the folks at MDFI are stepping up to help.
MDFI has a program called “Operation Skywalker.” It is an alum program that helps those in need, and Mr. Culik is one of those alumni. The goal is to raise $100,000 to help Mr. Culik get back on his feet, although that only covers half his legal bills. When there is injustice, we must help those affected.
If you would like to donate to help Mr. Culik, you can do so by donating at https://www.givesendgo.com/OPERATIONSKYWALKER
Wednesday, July 03, 2024
Jonathan Turley puts Presidential Immunity in perspective
No, President Biden, the Supreme Court Did Not Remove All Limits on the Presidency
President Joe Biden delivered an address from the White House last night on the presidential immunity decision by the Supreme Court. While pledging that he will defend the rule of law, President Biden misrepresented what that law is in the aftermath of Trump v. United States. While we have often discussed false constitutional claims by the President as well as other false statements, an address of this kind is particularly concerning in misleading citizens on the meaning of one of the most important decisions in history.
As I have previously written, I am not someone who has favored expansive presidential powers. As a Madisonian scholar, I favor Congress in most disputes with presidents. However, I saw good-faith arguments on both sides of this case and the Court adopted a middle road on immunity — rejecting the extreme positions of both the Trump team and the lower court.
One of the most glaring moments in the address came when President Biden declared that “for all…for all practical purposes, today’s decision almost certainly means that there are virtually no limits on what a president can do.”
That is not true.
The Court found that there was absolute immunity for actions that fall within their “exclusive sphere of constitutional authority” while they enjoy presumptive immunity for other official acts. They do not enjoy immunity for unofficial, or private, actions.
The Court has often adopted tiered approaches in balancing the powers of the branches. For example, in his famous concurrence to Youngstown Sheet & Tube Co. v. Sawyer, 343 U.S. 579 (1952), Justice Robert Jackson broke down the line of authority between Congress and the White House into three groups where the President is acting with express or implied authority from Congress; where Congress is silent (“the zone of twilight” area); and where the President is acting in defiance of Congress.
Here the Court separated cases into actions taken in core areas of executive authority, official actions taken outside those core areas, and unofficial actions. Actions deemed personal or unofficial are not protected under this ruling.
It is certainly true that the case affords considerable immunity, including for conversations with subordinates. However, this did not spring suddenly from the head Zeus. As Chief Justice John Roberts lays out in the majority opinion, there has long been robust protections afforded to presidents.
There are also a host of checks and balances on executive authority in our constitutional system. This includes judicial intervention to prevent violations of the law as well as impeachment for high crimes and misdemeanors.
President Biden’s hyper-ventilated response is crushingly ironic. He was vice president when President Barack Obama killed an American citizen without a trial or a charge. When former Attorney General Eric Holder announced the “kill list” policy (that included the right to kill any American citizen), he was met with applause, not condemnation.
The Obama-Biden administration then fought every effort by the family to sue the government. President Biden would have been outraged by any attempt of a Republican district attorney to charge him or President Obama with murder.
He would also be outraged by prosecutors pursuing criminal charges for the deaths associated with the deluge of undocumented persons over the Southern border.
In his address, President Biden also claimed that “the law would no longer” define “the limits of the presidency.”
That is also untrue. This case was remanded for the purpose of defining what of these functions would be deemed private as opposed to official. Even on official actions, former president Donald Trump could be prosecuted if the presumptive immunity is rebutted by prosecutors.
What was most glaring for many civil libertarians was President Biden’s portrayal of himself as a paragon of constitutional fealty. He declared that “I know I will respect the limits of the presidential powers as I have for the last three-and-a-half years.”
That was also untrue. President Biden has racked up an impressive array of losses in federal courts where he was found to have violated the constitution.
This includes rulings that his administration has exceeded his authority and engaged in racial discrimination in federal programs. Indeed, Biden has often displayed a cavalier attitude toward such violations.
For example, the Biden administration was found to have violated the Constitution in its imposition of a nationwide eviction moratorium through the Centers for Disease Control and Prevention (CDC). Biden admitted that his White House counsel and most legal experts told him the move was unconstitutional. But he ignored their advice and went with that of Harvard University Professor Laurence Tribe, the one person who would tell him what he wanted to hear. It was, of course, then quickly found to be unconstitutional.
Biden showed the same disregard over the unconstitutionality of his effort to unilaterally forgive roughly half a trillion dollars in student debt. Courts have already enjoined that effort as presumptively unconstitutional (though an appellate court in one of those cases relaxed aspects of the injunction).
The address was used to reinforce his “democracy is on the ballot” campaign theme. Pundits have repeated the mantra, claiming that if Biden is not elected, American democracy will perish.
While some of us have challenged these predictions, the other presidential candidates are missing a far more compelling argument going into this election. While democracy is not on the ballot this election, free speech is.
For many of us in the free speech community, President Biden has become the most anti-free speech president since John Adams. As discussed in my new book, “The Indispensable Right: Free Speech in an Age of Rage,” the Biden Administration has helped fund and maintain an unprecedented censorship system in the United States.
That record is hardly supportive for a president claiming to be the defender, if not the savior, of the Constitution.
President Joe Biden delivered an address from the White House last night on the presidential immunity decision by the Supreme Court. While pledging that he will defend the rule of law, President Biden misrepresented what that law is in the aftermath of Trump v. United States. While we have often discussed false constitutional claims by the President as well as other false statements, an address of this kind is particularly concerning in misleading citizens on the meaning of one of the most important decisions in history.
As I have previously written, I am not someone who has favored expansive presidential powers. As a Madisonian scholar, I favor Congress in most disputes with presidents. However, I saw good-faith arguments on both sides of this case and the Court adopted a middle road on immunity — rejecting the extreme positions of both the Trump team and the lower court.
One of the most glaring moments in the address came when President Biden declared that “for all…for all practical purposes, today’s decision almost certainly means that there are virtually no limits on what a president can do.”
That is not true.
The Court found that there was absolute immunity for actions that fall within their “exclusive sphere of constitutional authority” while they enjoy presumptive immunity for other official acts. They do not enjoy immunity for unofficial, or private, actions.
The Court has often adopted tiered approaches in balancing the powers of the branches. For example, in his famous concurrence to Youngstown Sheet & Tube Co. v. Sawyer, 343 U.S. 579 (1952), Justice Robert Jackson broke down the line of authority between Congress and the White House into three groups where the President is acting with express or implied authority from Congress; where Congress is silent (“the zone of twilight” area); and where the President is acting in defiance of Congress.
Here the Court separated cases into actions taken in core areas of executive authority, official actions taken outside those core areas, and unofficial actions. Actions deemed personal or unofficial are not protected under this ruling.
It is certainly true that the case affords considerable immunity, including for conversations with subordinates. However, this did not spring suddenly from the head Zeus. As Chief Justice John Roberts lays out in the majority opinion, there has long been robust protections afforded to presidents.
There are also a host of checks and balances on executive authority in our constitutional system. This includes judicial intervention to prevent violations of the law as well as impeachment for high crimes and misdemeanors.
President Biden’s hyper-ventilated response is crushingly ironic. He was vice president when President Barack Obama killed an American citizen without a trial or a charge. When former Attorney General Eric Holder announced the “kill list” policy (that included the right to kill any American citizen), he was met with applause, not condemnation.
The Obama-Biden administration then fought every effort by the family to sue the government. President Biden would have been outraged by any attempt of a Republican district attorney to charge him or President Obama with murder.
He would also be outraged by prosecutors pursuing criminal charges for the deaths associated with the deluge of undocumented persons over the Southern border.
In his address, President Biden also claimed that “the law would no longer” define “the limits of the presidency.”
That is also untrue. This case was remanded for the purpose of defining what of these functions would be deemed private as opposed to official. Even on official actions, former president Donald Trump could be prosecuted if the presumptive immunity is rebutted by prosecutors.
What was most glaring for many civil libertarians was President Biden’s portrayal of himself as a paragon of constitutional fealty. He declared that “I know I will respect the limits of the presidential powers as I have for the last three-and-a-half years.”
That was also untrue. President Biden has racked up an impressive array of losses in federal courts where he was found to have violated the constitution.
This includes rulings that his administration has exceeded his authority and engaged in racial discrimination in federal programs. Indeed, Biden has often displayed a cavalier attitude toward such violations.
For example, the Biden administration was found to have violated the Constitution in its imposition of a nationwide eviction moratorium through the Centers for Disease Control and Prevention (CDC). Biden admitted that his White House counsel and most legal experts told him the move was unconstitutional. But he ignored their advice and went with that of Harvard University Professor Laurence Tribe, the one person who would tell him what he wanted to hear. It was, of course, then quickly found to be unconstitutional.
Biden showed the same disregard over the unconstitutionality of his effort to unilaterally forgive roughly half a trillion dollars in student debt. Courts have already enjoined that effort as presumptively unconstitutional (though an appellate court in one of those cases relaxed aspects of the injunction).
The address was used to reinforce his “democracy is on the ballot” campaign theme. Pundits have repeated the mantra, claiming that if Biden is not elected, American democracy will perish.
While some of us have challenged these predictions, the other presidential candidates are missing a far more compelling argument going into this election. While democracy is not on the ballot this election, free speech is.
For many of us in the free speech community, President Biden has become the most anti-free speech president since John Adams. As discussed in my new book, “The Indispensable Right: Free Speech in an Age of Rage,” the Biden Administration has helped fund and maintain an unprecedented censorship system in the United States.
That record is hardly supportive for a president claiming to be the defender, if not the savior, of the Constitution.
Monday, July 01, 2024
Fasten your seatbelts
Patrick Veillette at aviationweek.com
Here is the link.
Here are some excerpts.
There is a common misperception that vortices are not a factor during cruise flight. While the majority of wake turbulence encounters occur during terminal phases of flight, a Flight Safety Foundation study by this author found that 13% of NASA Aviation Safety Reporting System (ASRS) wake turbulence reports occurred during high-altitude cruise flight.
The unique characteristics of a wake turbulence encounter at altitude can cause an elevated risk to the aircraft occupants as well as the structural integrity of the aircraft. The following ASRS report is indicative of a “Cross-Track Penetration.” This occurs when the trailing aircraft crosses another aircraft’s wake at a sharp angle.
“Our company’s Gulfstream IV departed Teterboro, New Jersey, on a routine night trip to Fort Myers (FMY), Florida, with a crew of three and two passengers, the company’s chairman and his wife. The trip was CAVU with smooth air… At approximately FL250 south of Sarasota on the arrival, Miami Center advised us we might see traffic crossing from right to left, 757 traffic enroute to Miami. We spotted the 757 cross so far ahead that we did not bother to acknowledge visual contract. Suddenly at about 15,000 feet and 300 knots, we hit what I thought was another aircraft, or we had an explosion on board the aircraft. The shock was something I have never experienced in my 19,964 hours of flight time or in any other physical encounter. It felt like we hit a 20-foot thick concrete wall at 300 knots.”
“Fortunately, we had completed the descent in range checklist. We were harnessed and the cabin seat belt sign was on. Everything in the cockpit that could move, did—manuals, clipboard, maintenance record, etc., even the steel approach plate holder secured on the yoke came up and hit me in the face. I thought we had a momentary total power failure, but that was not the case. We slowed to 200 knots because we were still unsure of damage to the Gulfstream. I went back to check on the cabin and passengers, and upon opening the door all the horror of total disaster was there. Debris was everywhere, broken china, smashed crystal glassware, silverware, even the stowed tray tables had lifted out of the side cabinets and traveled around the cabin. More importantly, the flight attendant was injured and the chairman’s wife lay on the floor in severe pain. Both had been jettisoned to the ceiling then slammed to the floor in a microsecond. I called ahead for an ambulance and asked approval for special handling priority for medical emergency. The chairman’s wife 12th and 14th vertebrae were broken and total recovery took a full year. The flight attendant was treated and released with severe bruises.” [NASA ASRS report no. 265754. December 1993.]
Here is the link.
Here are some excerpts.
There is a common misperception that vortices are not a factor during cruise flight. While the majority of wake turbulence encounters occur during terminal phases of flight, a Flight Safety Foundation study by this author found that 13% of NASA Aviation Safety Reporting System (ASRS) wake turbulence reports occurred during high-altitude cruise flight.
The unique characteristics of a wake turbulence encounter at altitude can cause an elevated risk to the aircraft occupants as well as the structural integrity of the aircraft. The following ASRS report is indicative of a “Cross-Track Penetration.” This occurs when the trailing aircraft crosses another aircraft’s wake at a sharp angle.
“Our company’s Gulfstream IV departed Teterboro, New Jersey, on a routine night trip to Fort Myers (FMY), Florida, with a crew of three and two passengers, the company’s chairman and his wife. The trip was CAVU with smooth air… At approximately FL250 south of Sarasota on the arrival, Miami Center advised us we might see traffic crossing from right to left, 757 traffic enroute to Miami. We spotted the 757 cross so far ahead that we did not bother to acknowledge visual contract. Suddenly at about 15,000 feet and 300 knots, we hit what I thought was another aircraft, or we had an explosion on board the aircraft. The shock was something I have never experienced in my 19,964 hours of flight time or in any other physical encounter. It felt like we hit a 20-foot thick concrete wall at 300 knots.”
“Fortunately, we had completed the descent in range checklist. We were harnessed and the cabin seat belt sign was on. Everything in the cockpit that could move, did—manuals, clipboard, maintenance record, etc., even the steel approach plate holder secured on the yoke came up and hit me in the face. I thought we had a momentary total power failure, but that was not the case. We slowed to 200 knots because we were still unsure of damage to the Gulfstream. I went back to check on the cabin and passengers, and upon opening the door all the horror of total disaster was there. Debris was everywhere, broken china, smashed crystal glassware, silverware, even the stowed tray tables had lifted out of the side cabinets and traveled around the cabin. More importantly, the flight attendant was injured and the chairman’s wife lay on the floor in severe pain. Both had been jettisoned to the ceiling then slammed to the floor in a microsecond. I called ahead for an ambulance and asked approval for special handling priority for medical emergency. The chairman’s wife 12th and 14th vertebrae were broken and total recovery took a full year. The flight attendant was treated and released with severe bruises.” [NASA ASRS report no. 265754. December 1993.]
Sunday, June 30, 2024
Recurrence Rate of Melanoma in Situ Excised With a 5-mm Excisional margin
From jamanetwork.com.
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